Article

Sensory stimulation is often provided to persons incurring severe
traumatic brain injury (TBI), but therapeutic effects are unclear. This preliminary study investigated neurobehavioral and neurophysiological
effects related to sensory stimulation on global neurobehavioral functioning,
arousal, and awareness. METHODS: A double-blind randomized placebo-controlled
trial where 15 participants in states of disordered consciousness (DOC), an
average of 70 days after TBI, were provided either the Familiar Auditory Sensory
Training (FAST) or Placebo of silence. Global neurobehavioral functioning was
measured with the Disorders of Consciousness Scale (DOCS). Arousal and awareness
were measured with the Coma-Near-Coma (CNC) scale. Neurophysiological effect was
measured using functional magnetic resonance imaging (fMRI). RESULTS: FAST (n =
8) and Placebo (n = 7) groups each showed neurobehavioral improvement. Mean DOCS
change (FAST = 13.5, SD = 8.2; Placebo = 18.9, SD = 15.6) was not different, but
FAST patients had significantly (P = .049; 95% confidence interval [CI] = -1.51,
-.005) more CNC gains (FAST = 1.01, SD = 0.60; Placebo = 0.25, SD = 0.70).
Mixed-effects models confirm CNC findings (P = .002). Treatment effect, based on
CNC, is large (d = 1.88, 95% CI = 0.77, 3.00). Number needed to treat is 2. FAST
patients had more fMRI activation in language regions and whole brain (P values
<.05) resembling healthy controls' activation. CONCLUSIONS:
For persons with DOC
29 to 170 days after TBI, FAST resulted in CNC gains and increased neural
responsivity to vocal stimuli in language regions. Clinicians should consider
providing the FAST to support patient engagement in neurorehabilitation.
CI - (c) The Author(s) 2015.

Langue : ANGLAIS